Active NPI
Christy Petty
- Home Health Aide
- South Lake Tahoe, CA
National Provider Identifier
1750108486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 1923 Apache Ave
South Lake Tahoe, CA 96150-4821 - Phone
- (530) 854-0939
- NPI assigned
- Sep 24, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Primary |
Addresses
Primary practice location
1923 Apache Ave
South Lake Tahoe, CA 96150-4821
Mailing address
PO Box 12282
Zephyr Cove, NV 89448-4282
Phone (530) 854-0939
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727136000000",
"number": "1750108486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12282",
"city": "ZEPHYR COVE",
"state": "NV",
"postal_code": "894484282",
"telephone_number": "530-854-0939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1923 APACHE AVE",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961504821",
"telephone_number": "530-854-0939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTY",
"first_name": "CHRISTY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-24",
"last_updated": "2024-09-24",
"certification_date": "2024-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Lake Tahoe, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.